Professional Billing Follow Up Rep II

Cincinnati Children's•Mount Vernon, VA

3d•Onsite

About The Position

The Professional Billing Follow Up Rep II is responsible for managing patient billing, ensuring procedures are billed according to contracts, and following up on payments. This role involves compiling and preparing patient charges, creating invoices and claim forms, and maintaining departmental systems. The position also acts as a liaison between various departments and provides financial support by determining eligibility for funding and counseling patients on coverage. Additionally, the role involves managing accounts receivable data, researching charges, and processing payments.

Requirements

High school diploma or equivalent
2+ years of work experience in a related job discipline

Responsibilities

Compile and prepare patient charges.
Prepare invoices, billings, UB-04 and 1500 claim forms to be sent to 3rd party payers for payment indicating individual line items for services and total costs.
Review charges.
Obtain and evaluate family, third party payers and agency resources for payment of charges.
Manage patient billing and ensure procedures are billed according to contracts.
Transmit or mail all paper and claims, and review correspondence and follow up as needed.
Maintain and update departmental system, including templates, and payer and physician information.
Act as a preceptor for new employees.
Perform specialty services functions.
Act as a resource within the department/division.
Provide instruction for performing non-routine functions.
Serve as a liaison between Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patent Financial Services and other Cincinnati Children's departments.
Counsel patient on third party coverage and present financial aspects.
Determine eligibility for State Medicaid, Social Security and other outside funding.
Complete necessary paperwork for eligible patients, including medical and financial applications.
Coordinate inpatient and outpatient admissions.
Coordinate information with the inpatient and outpatient charge systems.
Input charges and relative information.
Manage accounts receivable data and collection information, ensure timeliness and accuracy.
Research third party payers and community physician charges in order to maintain usual and customary as will as competitive charges.
Check and update charge master.
Conduct utilization review for the division from insurance companies and working in conjunction with Cincinnati Children's Utilization Review department.
Process, post, and balance payments to accounts timely, accurately, and in the correct period.
Provide Quality Assurance reports for the division.